Kyseem'S Unity Group Home, LLC

Organization Active NPI Community/Behavioral Health Agency · Pinetops, NC

NPI 1538488192 · NPPES record last updated Jan 20, 2022

Key facts

NPI
1538488192
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
MHL033076 (NC)
Legal business name
KYSEEM'S UNITY GROUP HOME, LLC
Practice address
408 East Tarboro Street
Pinetops, NC 27864-2786
Phone
(252) 902-7078
Fax
(252) 756-8586
NPI assigned
May 21, 2010
Organization subpart
No

Authorized official

Name
Mr. Dearl Ray Powell
Title
Executive Director
Phone
(252) 902-7078

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL033076 NC Yes

Addresses

Primary practice location

408 East Tarboro Street
Pinetops, NC 27864-2786

Mailing address

PO Box 129
Pinetops, NC 27864-0129
Phone (252) 902-6277

Other practice location 1

1510 Gold St N
Wilson, NC 27893-2340
Phone (252) 756-8586

Other practice location 2

404 Deans Street Wilson NC 27893
Wilson, NC 27893
Phone (252) 902-7078

Other practice location 3

304 Clyde Ave N
Wilson, NC 27893-2324
Phone (252) 756-8586

Other providers in Pinetops, NC

All providers in Pinetops, NC · Community/Behavioral Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.